Civitas Networks for Health® is a national collaborative of member organizations working to use health information exchange, health data, and multi-stakeholder, cross-sector approaches to improve health. We were in Anaheim, California, this year for the Civitas Networks for Health 2025 Annual Conference. Join us as we recap selected sessions from this year’s events!
Monday, September 29, 2025
The session featured experts from the National Committee for Quality Assurance (NCQA), Manifest MedEx (MX), a large non-profit Health Information Exchange (HIE) in California, and Inland Empire Health Plan (IEHP), which operates in California.
NCQA has focused on healthcare quality for 35 years. Wendy Talbot discussed NCQA’s role in setting accreditation standards and in using digital tools, such as the Data Aggregator Validation (DAV) program, to enhance healthcare quality, including data quality. NCQA is pursuing new initiatives to offer digital measurement services, which offer benefits such as lower costs, reduced variability, improved support for learning health systems, and better value-based care. The DAV program, a 23-week validation cycle, allows HIEs to take on from-the-source data validation on behalf of payers, building trust in data and reducing the need for direct audits by health plans.
Jason Buckner, representing MX, detailed the partnership between MX and IEHP. MX, a Qualified Health Information Organization (QHIO) serving 19 health plans, highlighted how IEHP’s incentive program encourages providers to contribute data to the HIE. This partnership has significantly reduced health plan validation hours by 75% across almost 1,000 validated sites, expanding MX’s network and improving data quality. MX adopted the Primary Source Verification (PSV) process as part of its onboarding for new providers, leading to better inbound data. IEHP’s pay-for-performance (P4P) offer in 2018 also included data quality scoring for hospitals, with IEHP assisting providers in meeting data quality challenges, particularly with progress notes.
Genia Fick from IEHP, a plan serving 1.5 million members and over 9,000 providers, shared their journey in connecting their network to the MX HIE. Starting with hospitals, they evolved from fax-dependent operations to electronic data exchange, initially with ADT feeds. IEHP emphasized the importance of data quality for patient care and building dashboards for routine monthly tracking and workflow improvements. IEHP’s efforts have resulted in 34 out of 34 network hospitals and 356 primary care sites being connected to MX’s HIE.
The session concluded with a summary emphasizing strategic partnerships, aligned incentives, data quality, and celebrating milestones as crucial steps for continuous improvement. The Q&A portion of the session revealed that data quality scoring at MX evolved from in-house solutions to a combination of purchased tools and customizations. The biggest hurdle with data for MX has been variations in progress and clinical notes. A combination of Incentives and the idea of being “left behind” was effective in encouraging provider participation. The IEHP model, particularly its geographically-focused and community-embedded position in the region it serves, is considered unique among payers with similar incentive programs. Presenters believe that this structure has been important to the positive engagement and growth in participation that IEHP and MX have seen within their provider community.
